Big Strides for Health-Care Reform

People fill out health insurance paperwork at an open-enrollment event in 2014 at a shopping mall in Jacksonville, Florida. (Photo: Sara Beth Glicksteen / New York Times)

One of the remarkable aspects of the politics of health care reform in America is the way that conservatives - even relatively mild, seemingly informed conservatives - have managed to keep believing that the Affordable Care Act is unraveling, despite the repeated failure of disaster predictions to come true.

Part of the way this works is that when it comes to Obamacare, the captive media and the right's pet "experts" hype every bit of bad news about the law, but go silent when the news is good (and, often, when the bad news turns out to be a false alarm).

How many people will even hear about the news that enrollments are once again running above expectations, and that the enrollment pool is getting younger?

Anyway, it's really helpful to have a new report from the Commonwealth Fund comparing the actual performance of the ACA with pre-implementation predictions. It turns out that premiums came in far below expectations. (The 2016 premium hikes rolled back some of this positive news, but overall costs still look very good.)

On enrollments: Fewer people than expected signed up for the exchanges, but an important reason was that fewer employers than expected ended coverage and moved their employees into the individual market.

Meanwhile, Medicaid expanded more than projected - and the overall reduction in the number of uninsured Americans was pretty much in line with forecasts.

So the program is achieving its goals, albeit with a somewhat different mix of insurance types than was originally predicted, and doing so more cheaply than anticipated. That's a big success story - and remember, the critics scoffed at those expectations and prophesied utter disaster.

Where's the Rubiomentum?

I'm not a political scientist. But I am someone who follows politics, and likes to keep track of conventional wisdom.

So I paid a lot of attention when Senator Marco Rubio was recently elevated to perceived front-runner status for the Republican presidential nomination, basically because on paper he seemed like the natural replacement for the fatally charisma-lacking Jeb Bush.

And maybe it will still happen. But Mr. Rubio hasn't gotten a flood of high-level endorsements, and he hasn't shown any signs of achieving a breakthrough in the polls. I'm not a huge believer in prediction markets, which seem more to reflect conventional wisdom than to offer profound insights, but it's noteworthy that they are less and less convinced that Mr. Rubio is really a front-runner, and they now take both Donald Trump and Ted Cruz seriously.

So what's going on? Insiders may dislike Mr. Rubio because he has a habit of abandoning his allies when the going gets tough; or maybe there are personal-life issues we haven't heard about. Meanwhile, voters aren't seeing much about Mr. Rubio that would give them good reasons to support him.

If Rubiomentum doesn't surface soon, it's hard to imagine when it ever will. And I must say, it will be fun watching supposedly moderate Republicans explain why Mr. Trump or Mr. Cruz are, in the end, better than Hillary Clinton.

Big Strides for Health-Care Reform

People fill out health insurance paperwork at an open-enrollment event in 2014 at a shopping mall in Jacksonville, Florida. (Photo: Sara Beth Glicksteen / New York Times)

One of the remarkable aspects of the politics of health care reform in America is the way that conservatives - even relatively mild, seemingly informed conservatives - have managed to keep believing that the Affordable Care Act is unraveling, despite the repeated failure of disaster predictions to come true.

Part of the way this works is that when it comes to Obamacare, the captive media and the right's pet "experts" hype every bit of bad news about the law, but go silent when the news is good (and, often, when the bad news turns out to be a false alarm).

How many people will even hear about the news that enrollments are once again running above expectations, and that the enrollment pool is getting younger?

Anyway, it's really helpful to have a new report from the Commonwealth Fund comparing the actual performance of the ACA with pre-implementation predictions. It turns out that premiums came in far below expectations. (The 2016 premium hikes rolled back some of this positive news, but overall costs still look very good.)

On enrollments: Fewer people than expected signed up for the exchanges, but an important reason was that fewer employers than expected ended coverage and moved their employees into the individual market.

Meanwhile, Medicaid expanded more than projected - and the overall reduction in the number of uninsured Americans was pretty much in line with forecasts.

So the program is achieving its goals, albeit with a somewhat different mix of insurance types than was originally predicted, and doing so more cheaply than anticipated. That's a big success story - and remember, the critics scoffed at those expectations and prophesied utter disaster.

Where's the Rubiomentum?

I'm not a political scientist. But I am someone who follows politics, and likes to keep track of conventional wisdom.

So I paid a lot of attention when Senator Marco Rubio was recently elevated to perceived front-runner status for the Republican presidential nomination, basically because on paper he seemed like the natural replacement for the fatally charisma-lacking Jeb Bush.

And maybe it will still happen. But Mr. Rubio hasn't gotten a flood of high-level endorsements, and he hasn't shown any signs of achieving a breakthrough in the polls. I'm not a huge believer in prediction markets, which seem more to reflect conventional wisdom than to offer profound insights, but it's noteworthy that they are less and less convinced that Mr. Rubio is really a front-runner, and they now take both Donald Trump and Ted Cruz seriously.

So what's going on? Insiders may dislike Mr. Rubio because he has a habit of abandoning his allies when the going gets tough; or maybe there are personal-life issues we haven't heard about. Meanwhile, voters aren't seeing much about Mr. Rubio that would give them good reasons to support him.

If Rubiomentum doesn't surface soon, it's hard to imagine when it ever will. And I must say, it will be fun watching supposedly moderate Republicans explain why Mr. Trump or Mr. Cruz are, in the end, better than Hillary Clinton.